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Erwin I take my hat off for you... You're a STAR!! Nic 62/20 On 27 November 2014 at 03:55, Erwin Matthews <[log in to unmask]> wrote: > My PWP, now 23 years since diagnosis, was trialed on a 20mg in 2ml dose of > Apomine (apomorphine hydrochloride) plus saline in a 10ml capacity syringe > beginning in September 2013. The solution was delivered continuously for > 12 hours by a CRONO APO-go II pump through a Unomedical Neria infusion > needle. Over several months it was thought my PWP would benefit by infusing > Apomine 24/7 and the Apomine was gradually increased to 120mg in 12ml plus > 8 ml of saline to fill a 20 ml syringe. In addition to the 120mg of > Apomine, my PWP currently takes per day 1x Sinemet 250/25, 5x Sinemet > 100/25, 5x Sinemet CR 200/50, 5x Deralin 40 and 2x Motilium 10 (anti-nausea > for Apomine). > > Because we live some distance from experienced support, we have a spare > pump in case of failure so each pump is used on alternate days. > > A clear plastic dressing covers the infusion site and sticky tape supports > the supply tubing from the pump which is carried in a small bag held around > the neck. An alternative is a belt around the waist. The pump must be > either removed or placed in a waterproof container while showering. > > The infusions have all been made in the lower abdomen, moving the > insertion points daily to avoid previous locations where small firm nodules > occur beneath the skin. Nodule formation seems to be minimised by > application of a small hand held vibrator and Calmoseptine ointment. > Periodically, I apply a small hand held ultrasonic massager to the whole > area. > > There are two types of "needle"; we use the more expensive 8mm long type > that is simply pressed against the skin and held there by a ring of > adhesive, the other is the 19mm long winged infusion or "butterfly" type > which requires the needle to be inserted at a 45 degree angle (we have some > of these for emergency use only, not intending to use them routinely). > > Apomine has to be supplied through our local hospital's pharmacy. We order > on-line the accessory kits containing a month's supply of infusion needles, > syringes and saline. Plastic dressings for the infusion sites, sticky tape, > alcohol swabs, antiseptic creams, hand sanitiser gel are bought at our > local pharmacy. Sharps boxes for disposal of infusions points, syringe > needles and empty glass ampoules are free at our local Community Nursing > Centre. > > My PWP is the only Apomine user in our local area. Local nursing staff are > always interested, never having seen Apomine in use before. My PWP has > never attached an infusion point or prepared a syringe for herself partly > due to hand stability and eyesight problems. She lacks confidence with > inexperienced nursing staff following a couple of incidents. Common sense > suggests self administration may be useful in times of emergency. > > Some months ago neurologists had my PWP reduce her conventional Sinemet > dosage by half. Within a week she became so immobile she was unable to > stand, needing much more assistance than usual to rise from chairs and the > toilet. After I experienced shoulder and back problems from assisting her > she returned to her previous quantities of Sinemet. > > It is believed that spinal problems have been the cause of her left leg > intermittently failing to support her since before she began Apomine and > her mobility problems have now increased to the extent that she has to be > wheel chair bound whenever we are away from home. At home she uses a walker > and then never walks more than 20 paces. After showering and dressing (we > have help in to assist her) she frequently needs a chair to sit on when > pushing her walker from the bedroom to where she has breakfast. She has not > fallen for quite some time; needing emergency seating occurs daily. > > How effective is Apomine? On her current 24/7 dose of Apomine, she begins > her conventional medications at 6am, then is eager for Sinemet at 10am > because of shaking in her body and legs , from 1pm she is "off" and tired > and her 2pm Sinemet may not kick in till 4pm, then she is "hanging out" for > Sinemet at 6pm and from 8.30pm she feels "useless" until her 10pm Sinemet > in bed. > > Around 10pm I change over the Apo pumps which takes about half an hour > filling a new syringe, attaching and removing infusion points. My PWP has > incontinence problems; sleeping on most nights is disturbed, even using > incontinence pants and pads, so she may take a Sinemet 250/25 around 2am. > Recently I encouraged her to take half a sleeping pill at bedtime but she > found that caused too much drowsiness the next morning. > > Perhaps this wordy description may give you some idea of one PWP's > experience with Apomine. > > > On 18/11/2014 11:05, A Phillips wrote: > >> Anyone on this list using the apomorphine pump ? It's ben suggested I >> try it as off-periods are driving me crazy and I'm terrified of DBS. >> >> ---------------------------------------------------------------------- >> To sign-off Parkinsn send a message to: mailto:[log in to unmask] >> utoronto.ca >> In the body of the message put: signoff parkinsn >> >> > ---------------------------------------------------------------------- > To sign-off Parkinsn send a message to: mailto:[log in to unmask] > utoronto.ca > In the body of the message put: signoff parkinsn > ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn